Analysis of the clinical therapeutic effect of thoracoscopy and laparoscopy combined radical operation for esophageal carcinoma
10.3760/cma.j.issn.1673-4203.2018.11.004
- VernacularTitle:胸腹腔镜联合食管癌根治术的临床疗效分析
- Author:
Jingping PENG
1
;
Li ZHANG
Author Information
1. 650032,解放军昆明总医院心胸外科
- Keywords:
Esophageal neoplasms;
Thoracoscopes;
Laparoscopes;
Surgical procedures,operative;
Clinical efficacy
- From:
International Journal of Surgery
2018;45(11):735-739
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical therapeutic effect of thoracoscopy and laparoscopy combined radical operation for esophageal carcinoma and provide reference for clinical treatment.Methods The clinical data of five hundred and twenty-one patients with esophageal cancer in Kunming General Hospital of PLA from June 2010 to May 2017 were analyzed retrospectively.The patients were divided into experimental group (n =276) and control group (n =245) according to the type of procedure.The experimental group was treated with thoracoscopy and laparoscopy,and the control group was treated with open esophagectomy.The intra-operative condition (surgery time,intraoperative blood loss),postoperative condition (postoperative drainage volume,postoperative catheterization time,postoperative hospital stay),postoperative complications (pulmonary infection,anastomotic fistula,recurrent nerve paralysis,chylothorax,gastric emptying delayed,pleural effusion,incisal infection) and life quality [quality of life questionnaire C30 (QLQ-C30) version 3.0 core,quality of life questionnaire-OES18 (QLQ-OES18)] were compared between the two groups.The measurement data were expressed by ((x) ±s) and the two group were compared with the t test.The count data were expressed by percentage (％) and inter-group comparisons were performed by chi-square test between the two groups.Results The operation time [(238.7± 32.4) min vs (245.1 ± 34.6) min],period of catheter indwelling [(5.7 ± 1.2) d vs (8.7 ± 2.6) d] and hospital stay [(9.6 ± 2.7) d vs (1 1.4 ±4.6) d] were shorter,the amount of intraoperative bleeding [(198.6 ±41.2) ml vs (231.9 ±43.5) ml] and post-operation drainage [(221.7 ±32.1) ml vs (257.8 ±38.6) ml] were less,and the morbidity of lung infection,anastomotic fistula and incision infection were lower in the experimental group than in the control group.The scores of emotional function,physical function and overall health status which belong to QLQ-C30 scale were higher and the scores of difficulty in feeding,reflux,pain,loss of appetite and cough which belong to QLQ-OES18 were lower in the experimental group than in the control group.The differences between the two groups had statistical significance (P ＜ O.05).Conclusion Compared with open esophagectomy,thoracoscopy and laparoscopy combined radical operation for esophageal carcinoma has an advantage in improving the intra-operative and postoperative condition,reducing the postoperative complication rate and enhancing the postoperative life quality.
